25-hydroxyvitamin-d-2 and Nutrition-Disorders

59 elderly patients (mean age 82) with femoral neck fractures were randomised into two groups. 27 patients received daily an oral nutrition supplement (250 ml, 20 g protein, 254 kcal) for a mean of 32 days; 32 patients acted as controls. On admission most patients had nutritional deficiencies. Despite being offered adequate quantities, nutritional requirements were not met during the hospital stay. Clinical outcome was significantly better in the supplemented group (56% favourable course vs 13% in controls) during the stay in the convalescent hospital. The rates of complications and deaths were also significantly lower in supplemented patients (44% vs 87%). 6 months after the fracture the rates of complications and mortality were significantly lower in supplemented patients (40% vs 74%). The median duration of hospital stay was significantly shorter in the supplemented group (24 vs 40 days). Thus the clinical outcome of elderly patients with femoral neck fracture can be improved by once daily dietary oral supplementation.

Topics: 25-Hydroxyvitamin D 2; Accidental Falls; Administration, Oral; Aged; Aged, 80 and over; Dietary Proteins; Energy Intake; Energy Metabolism; Evaluation Studies as Topic; Female; Femoral Neck Fractures; Food, Fortified; Humans; Male; Middle Aged; Nutrition Disorders; Nutritional Status; Prospective Studies; Randomized Controlled Trials as Topic; Risk Factors

The work presented here examines the possible effects of nutritional deficiencies on the characteristics of the plasma transport protein for vitamin D and its metabolites (vitamin D binding protein, DBP) in the growing rat. Deficiencies in both dietary protein intake and dietary energy intake may decrease the concentration of DBP in the circulation, although plasma DBP was not affected by dietary Ca deficiency. None of the dietary factors examined appears to influence the affinity of DBP for its major ligand, 25-hydroxycholecalciferol (25(OH)D(3)). Protein-deficient rats seemed to have difficulty in maintaining adequate concentrations of 1,25-dihydroxycholecalciferol (1,25(OH)(2)D(3)) in the circulation. The sensitivity of DBP to dietary protein and energy intake may constitute a novel mechanism that may help to explain the observed associations between malnutrition and the development of metabolic bone disease, through alterations to the cellular availability of vitamin D ligands to DBP.

Topics: 25-Hydroxyvitamin D 2; Analysis of Variance; Animals; Calcitriol; Calcium, Dietary; Liver; Male; Nutrition Disorders; Organ Size; Rats; Rats, Sprague-Dawley; Statistics, Nonparametric; Vitamin D-Binding Protein; Weaning

A cross-sectional study was carried out of 412 healthy and 226 chronically malnourished children in Recife, Brazil. Anthropometric measurements, x-rays of hands and wrists, and biochemical data related to skeletal growth were obtained. Levels of plasma 25 hydroxyvitamin D were measured in both groups of children and both showed higher concentrations than those reported for normal European children. The high levels of 25 hydroxyvitamin D found in these two groups of Brazilian children are probably the result of the intense solar radiation in this part of Brazil and argue against the diet being an important source of vitamin D in poorly nourished children. Some bone abnormalities were seen in the underprivileged group of children but in view of our findings these were more likely to be a result of protein-energy malnutrition than rickets.

Topics: 25-Hydroxyvitamin D 2; Adolescent; Body Weight; Bone and Bones; Bone Development; Brazil; Child; Child Nutritional Physiological Phenomena; Ergocalciferols; Female; Humans; Male; Nutrition Disorders; Radiography; Socioeconomic Factors; Vitamin D